Provider Demographics
NPI:1184807059
Name:FLETCHER'S DENTAL ASSOCIATES, P.A.
Entity type:Organization
Organization Name:FLETCHER'S DENTAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:PIER
Authorized Official - Last Name:RIDDLE-FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-298-2700
Mailing Address - Street 1:3320 SAINT LUKES LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-5704
Mailing Address - Country:US
Mailing Address - Phone:410-298-2700
Mailing Address - Fax:410-298-7299
Practice Address - Street 1:3320 SAINT LUKES LN
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-5704
Practice Address - Country:US
Practice Address - Phone:410-298-2700
Practice Address - Fax:410-298-7299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD114421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty